Surgical resection of recurrent extrahepatic hepatocellular carcinoma with tumor thrombus extending into the right atrium under cardiopulmonary bypass: a case report and review of the literature

Ohta, M.; Nakanishi, Chikashi; Kawagishi, Naoki; Hara, Yasuyuki; Maida, Kai; Kashiwadate, Toshiaki; Miyazawa, Kohtaro; Yoshida, Shigeo; Miyagi, Shigehito; Hayatsu, Yukihiro; Kawamoto, Shunsuke; Matsuda, Yasushi; Okada, Yoshinori; Saiki, Yoshikatsu; Ohuchi, Noriaki

doi:10.1186/s40792-016-0241-7

Cited by 21 publications

(29 citation statements)

References 22 publications

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“…In 8 patients with recurrent HCC, treatment had been done with hepatectomy in 2 (25%) patients [1,30], TACE in 3 (37.5%) patients [1,19], and TACE plus direct-acting antiviral therapy (sofosbuvir) [5], radiofrequency ablation plus doxorubicin and sorafenib chemotherapy [15], and TACE plus radiofrequency ablation plus sorafenib [40] in 1 (12.5%) patient each. The clinical symptoms were described for 36 patients, with pedal edema being the most common (Table II).…”

Section: Resultsmentioning

confidence: 99%

Hepatocellular carcinoma with right atrial tumor thrombus: a meta-analysis

Yuan

Guo²

2020

Preprint

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Background: Hepatocellular carcinoma with right atrial tumor thrombus is uncommon but with a dismal prognosis. Methods: By comprehensive retrieval of the pertinent literature published since 2000, 53 reports were collected with 187 patients recruited into this study. The quantitative data were expressed in mean±standard deviation with range and median values and were compared by independent samples t -test. The categorical variables were compared by Chi-square or Fisher exact test with continuity correction. Results: The survival rate of patients receiving transarterial chemoembolization was 33.3% and that of surgical patients was 41.9%. The survival time of patients with transarterial chemoembolization treatment was longer than that of surgical patients, but lack of a statistical significance. Conclusions: Even though advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy, the the present study showed that patient prognoses were improved and survival time was elongated with the advances of active treatments such as transarterial chemoembolization and surgical treatments. Active treatments are advised to patients with hepatocellular carcinoma with right atrial tumor thrombus in order to improve patients’ survival.

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Section: Resultsmentioning

confidence: 99%

Hepatocellular carcinoma with right atrial tumor thrombus: a meta-analysis

Yuan

Guo²

2020

Preprint

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“…Chronic hepatatis C [1,18,19,29,30,38,42 Edema, lower extremity [5, 7-10, 14, 16, 34, 39, 42, 45, 46, 51] 13 (13.5) Ascites [1,5,8,19,21,24,34,39,42,51] 10 (10.4)…”

Section: Discussionmentioning

confidence: 99%

“…The timing of diagnosis of RA thrombi was described for 53 patients: at HCC recurrence in 5 (9.4%) patients [1,5,13,15,30], at HCC progression in 13 (24.5%) patients [1, 17, 19, 34, 36-38, 40, 42, 48, 51], and at the first HCC diagnosis in 35 The size of liver tumor was described for 57 patients. The calculated tumor size was 8.4±4.1 (range, 1.3-21; median, 7.6) cm, with only 3 (5.3%) tumors of 3 patients <3 cm [1,6,51].…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…One patient receiving a two-stage operation survived 6 months[38]. The surgical operation was performed under cardiopulmonary bypass (CPB) in 18 patients[2, 3, 18, 21, 28-30, 35, 38, 43, 45, 51, 52], under veno-venous bypass in 1 patient[25] and with total hepatic vascular exclusion (THVE) with 6 no CPB in 15 patients[3,4,12,13,20,42,49,50].The operation time was 9.1±2.5 (range, 5.6-12.3; median 9.0) hours (n=12)[4, 7, 12, 25, 29-31, 35, 42, 45, 51, 52], the CPB time was 40.6±23.9 (range, 16-100; median, 38) min (n=9)[2,7,12,29,30,45,50,51,52], and the hepatic occlusion time was 29.4±26.3 (range, 10-87; median, 19) min (n=11)[4, 12, 13, 20, 25, 29-31, 42, 45, 52]. The total blood loss amount was 3.562,0±2,692.2 (range, 650-8,200; median, 2,692) mL (n=10)[7, 13, 25, 29-31, 35, 42, 51, 52].…”

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confidence: 99%

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Hepatocellular carcinoma with right atrial tumor thrombus: a systematic review

Yuan

Guo²

2020

Preprint

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Background: Hepatocellular carcinoma with right atrial tumor thrombus is uncommon but with a dismal prognosis. Methods: By comprehensive retrieval of literature published between 2000 and 2019, 53 reports were obtained with 187 patients recruited into this study. The extracted data included patient characteristics, tumor characteristics, treatment, follow-up and outcomes. Statistical analyses applied were student t , Fisher exact and I 2 tests. Patients were devided into 6 groups according to treatment of choices: transarterial chemoembolization (TACE), surgery, radiotherapy, chemotherapy, interventional treatment and supportive care. Results: The overall survival rate of this cohort was 40.8%. The survival rate of patients receiving TACE was 33.3% and that of surgical patients was 41.9%. The survival time of patients with TACE was longer than surgical patients, but lack of a statistical significance. Patients had a follow-up of 15.7±16.6 (median 10) months. The patients receiving radiotherapy had the longest follow-up among all groups. Intra- and/or extrahepatic recurrence of hepatocellular carcinoma was the major mobidity. The mortality rates in a decremental sequence for patients receiving different treatments were supportive care >radiotherapy >surgery >TACE >interventional treatment. No difference was found in mortality between patients reported from case reports and those from non-case reports. Conclusions: Even though advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy, the the present study showed that patients’ prognosis was improved and survival time elongated with active treatments such as TACE and surgery. The present systematic review reveals improved outcomes with active treatments against conservative treatments.

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“…Hepatocellular carcinoma invading the IVC and then causing a tumor thrombus extending into the RA is relatively rare. According to the literature, the incidence rate is usually 1%–4% . However, the incidence of vascular invasion increases with increasing tumor size, and vascular invasion has been reported to occur in 82% of patients with a serum AFP level >1000 µg/L and a tumor diameter >5 cm .…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report

2019

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This is a case report of a 45-year-old patient admitted with the symptom of bilateral leg swelling. Ultrasonography revealed a hyperechoic mass in the right lobe of the liver, which invaded the right hepatic vein (RHV) and extended into the inferior vena cava (IVC) and right atrium (RA). Based on the high alpha-fetoprotein (AFP) level and the ultrasonography findings, the patient was diagnosed as having hepatocellular carcinoma (HCC) with a RHV, IVC, and RA tumor thrombus and secondary Budd-Chiari syndrome (BCS). HCC with a tumor thrombus extending into the IVC and RA has rarely been observed, and as a cause of secondary BCS, this type of HCC has been even more rarely reported. K E Y W O R D S hepatocellular carcinoma, inferior vena cava, right atrium, tumor thrombus S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. Movie S1. Transthoracic echocardiography, apical 4-chamber view, revealed a thrombus (yellow arrow) in the RA. RA = right atrium; RV = right ventricle; LA = left atrium; LV = left ventricle; TT = tumor thrombus; IVC = inferior vena cava. Movie S2. Transthoracic echocardiography showed the TT in the RA coming from the IVC and the thrombus in the RHV and IVC (red arrow). RA = right atrium; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava; RHV = right hepatic vein. Movie S3. Abdominal ultrasound showed the TT coming from the IVC (red arrow) and integrating with the liver mass (white arrow). LV = left ventricle; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava. Movie S4. Transthoracic echocardiography showed that the tumor thrombus in the RHV, IVC (red arrow) and RA was continuous. RA = right atrium; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava; RHV = right hepatic vein. How to cite this article: Chen M, Huang X, Yang Q. Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report. Echocardiography.

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Surgical resection of recurrent extrahepatic hepatocellular carcinoma with tumor thrombus extending into the right atrium under cardiopulmonary bypass: a case report and review of the literature

Cited by 21 publications

References 22 publications

Hepatocellular carcinoma with right atrial tumor thrombus: a meta-analysis

Hepatocellular carcinoma with right atrial tumor thrombus: a meta-analysis

Hepatocellular carcinoma with right atrial tumor thrombus: a systematic review

Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report

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